od   Christian  people,  bere  lies  ao  inestimable  leap;  take  all 
eed  thereof,  ir)  all  carefulness  en9ploy  it;  with  bigb  recorr;per;se 
bea.vy  penalty  will  it  one  day  be  required  back. 


Ir  wi 


TREMOTE  STORAGE 


•   f  .     . 


The'  Illinois  State  Board  of  Health,  as  created  by  Law,  is  charged  with  the  general  supervis 
of  the  interests  of  the  health  and  life  of  the  people.      In  view  of  the  great  death  rate 
among   infants,  especially    during   the    summer    months,  attributable  to  a 
large  extent  to  improper  feeding  and  to  impure  foods,  it  becomes 
the  duty  of  the  Board  to  warn  the  people  against  those 
features  of  infant  feeding  of  the  greatest  danger 
to  the  child  and  to  instruct  and  advise 
as  to  those   methods  which 
will  reduce   the  death 
rate  to  the  min- 
imum. 


THIRD  REVISED   EDITION  APRIL  2,  1906. 


THE  FEEDING  AND  CARE  OF  INFANTS— THE  SELEC- 
TION AND  HOME  MODIFICATION  OF  COW'S  MILK 

CIRCULAR  ISSUED  BY  THE  ILLINOIS  STATE  BOARD  OF  HEALTH, 

1906. 


"The  question  whether  a  child  shall  be  strong  and  robust  or  a  weakling 
is  often  decided  by  its  food  during  the  first  three  months. 

"The  problem  is  not  simply  to  save  the  child's  life  during  the  perilous 
first  year,  but  to  adopt  those  means  which  shall  tend  to  the  healthy  and 
normal  growth  of  the  child." — Dr.  L.  Emmett  Holt. 

THE  DEATH  RATE  OF  INFANTS  IS  EXCEEDINGLY  HIGH— ONE-FIFTH 
TO  ONE-THIRD  OF  ALL  CHILDREN  BORN  DIE  BEFORE  REACHING 
THE  SECOND  YEAR  OF  LIFE. 

The  statistics  of  all  localities,  both  city  and  country,  show  that  the  high- 
est mortality  of  life  is  during  the  first  year.  In  the  State  of  Illinois,  about 
one-fifth  of  all  who  are  born,  die  during  the  first  year.  In  large  cities, 
as  in  Chicago  and  New  York,  this  death  roll  has  been  increased  at  times 
\-^f  until  it  reaches  the  figure  of  one-third. 

One-fifth  of  all  deaths  among  infants  occur  during  the  month  of  July. 
The  vast  majority  in  the  summer  months. 

Hot  weather  does  not  kill  babies  in  itself.  Deaths  are  chiefly  due  to  the 
effects  of  the  hot  weather  upon  the  food. 

An  exceedingly  large  number  of  infants,  even  those  born  under  the  best 
conditions  and  afforded  the  natural  food  of  the  mother's  milk,  fail  to 
weather  the  storms  of  the  first  and  second  summers.  Among  the  poor  and 
especially  among  those  infants  deprived  of  mothers  milk,  the  death  rate 


2 


•  V 


assumes  shocking  proportions. 


THE  VAST  MAJORITY  OF  INFANTS  DYING  DURING  THE  FIRST  YEAR 
DIE  FROM  IMPROPER  FOOD  OR  THEIR  INABILITY  TO  DIGEST  AND 
ASSIMILATE  IT. 

While  the  mortality  among  all  young  infants  is  high,  it  must  be  appreci- 
ated that  digestive  disorders  are  the  chief  cause  of  death.  It  must  be  fur- 
ther remembered  that  the  mortality  among  those  artificially  fed  is  vastly 
greater  than  among  those  nursed  by  the  mother.  The  infant  deprived  of 
the  mother's  milk  has  its  chances  of  life  and  health  materially  lessened.  The 
adoption  of  any  other  food  when  the  mother  is  capable  of  nursing  the  in- 
fant, incurs  dangers  to  the  child  which  makes  such  action  almost 
criminal. 


K 


JAN.    FEB.    MAR.  APL.  MAY  JUM.   JUL.    AUG.  SLP.     OCT.    NOV.    DE-C 


CHILDREN  UNDER  I  Yr. 

1-2  Yr. 

2-5  Yr. 
5-15  Yr. 
OVER  15  Yrs. 

CHART    SHOWING  MORTALITY  IN  LARGE  CITIES   BY  MONTHS  AND 

BY  AGES. 

(It  will  be  seen  that  during  the  month  of  July  there  were  more  deaths  among  those  under'l 
year  of  age  than  among  all  persons  over  15  years.) 


BREAST  FEEDING. 

MOTHER'S  MILK  IS  THE  NATURAL  AND  ONL\  PERFECT  FOOD  FOR 
THE  INFANT.  ANY  SUBSTITUTION  FOR  MOTHER'S  MILK  MUST  BE 
LOOKED  UPON  AS  A  DANGEROUS  UNDERTAKING  JUSTIFIED  ONLY 
BY  NECESSITY. 

There  is  no  perfect  substitute  for  mother's  milk.  This  applies  to  the 
milk  of  the  wet-nurse,  to  the  milk  of  the  cow  or  the  goat,  to  condensed 
milk  and  to  the  artificial  manufactured  food  so  widely  advertised. 

When  it  becomes  necessary,  as  it  sometimes  is  necessary,  to  substitute 
other  food  for  the  mother's  milk,  the  substitute  should  be  a  food  which  is  as 
much  like  normal  woman's  milk  as  possible. 

A  healthy  mother  whose  baby  is  able  to  nurse  properly  need  have  little 
concern  as  to  substitutes  for  several  months. 

If  the  mother  is  able  to  nurse  and  there  is  no  valid  reason  why  she  should 
not  continue  nursing,  the  infant  should  have  nothing  but  its  mother's  milk 
for  the  first  six  months  of  life  at  least. 

For  many  reasons,  too  lengthy  to  be  discussed  here,  the  physician  may 
decide  that  the  interests  of  the  infant  or  of  the  mother  require  that  the 
infant  be  weaned.  The  weaning  of  an  infant  is  accompanied  by  so  much 
danger  to  the  child,  especially  in  hot  weather,  however,  that  it  is  the  part 
of  wisdom  to  seek  the  advice  of  a  physician  before  undertaking  it. 

Except  under  special  conditions,  weaning  should  not  be  attempted  until 
every  effort  has  been  made  to  improve  the  milk  of  the  mother.  If  the  milk 
is  insufficient,  a  physician  should  be  consulted  before  artificial  foods  are 
adopted. 

When  the  breast  milk,  while  plentiful  and  apparently  good  in  quality, 
fails  to  nourish  the  infant,  a  change  of  the  mother's  diet  and  habits  will 
often  give  excellent  results.  If  the  infant  does  not  increase  in  weight,  the 
free  use  of  fats  by  the  mother  will  soon  cause  an  improvement. 

The  richness  of  the  milk  may  often  be  increased  by  plenty  of  meat,  eggs 
animal  broths  and  other  animal  foods.  The  richness  may  be  decreased  by 
omitting  or  decreasing  these  foods  and  by  plenty  of  fruits  and  cereals. 

Over-eating  and  too  little  exercise  will  often  increase  those  elements  in 
the  milk  which  render  it  most  indigestible.  Malt  extracts  and  alcohol  in 
the  form  of  beers  and  ales  increase  the  richness  of  the  milk,  but  the  regu- 
lar use  of  these  or  other  alcoholic  drinks  frequently  does  more  harm  than 
good.  Alcohol  has  been  known  to  appear  in  the  milk,  and  stale  beer  drunk 
by  the  mother  has  occasioned  serious  illness  of  the  child. 

Tne  nursing  mother  should  drink  plenty  of  pure  water.  She  should  drink 
tea  sparingly  and  should  not  drink  strong  tea  at  all.  There  is  no  better 
food  for  the  nursing  woman  than  good  milk.  She  should  use  it  freely. 

Foods  which  may  be  eaten  by  some  nursing  mothers  without  affecting 
their  babies,  cannot  be  eaten  by  others.  Tomatoes,  strawberries  and  lettuce 
cannot  be  eaten  by  some.  For  most  mothers  these  fresh  foods  are  of  great 
value  and  should  be  eaten  freely. 

RULES  OF  DIET  MUST  NOT  BE  TOO  RIGIDLY  MADE.  THERE  IS  NO 
METHOD  OF  FEEDING  SO  IMPORTANT  THAT  IT  SHOULD  BE  CONTIN- 
UED IF  IT  DISAGREES  WITH  THE  MOTHER.  The  mother  must  be  in 
good  health  to  produce  satisfactory  milk.  Any  method  adopted  to  increase 
the  quantity  or  quality  of  milk  must  primarily  prove  beneficial  or,  at 
least  not  injurious  to  the  mother 


DRUGS  MUST  NOT  BE  GIVEN  TO  THE  NURSING  MOTHER  EXCEPT 
ON  THE  DIRECTION  OF  A  COMPETENT  PHYSICIAN.  Opium,  senna,  rhu- 
barb and  other  drugs  taken  by  the  mother  may  appear  in  the  milk  and 
may  poison  the  child. 

Great  fatigue,  exhaustion,  excitement,  sudden  fright,  grief,  anger  or  pas- 
sion of  the  mother  have  occasioned  illness  of  infants.  Under  such  condi- 
tions it  is  often  better  to  draw  the  milk  and  give  the  infant  some  other 
food  and  to  avoid  nursing  until  the  mother  regains  self-control. 

The  mother  herself  should  appreciate  that  the  comfort  and  health  of 
herself  and  her  infant  will  depend  greatly  upon  intelligence  displayed  in 
nursing. 

The  breasts  should  be  kept  scrupulously  clean.  The  breasts  and  nipples 
should  be  washed  with  pure  water  after  each  nursing. 

During  the  first  day  afterbirth,  the  child  should  be  put  to  the  breast  once 
in  six  hours;  on  the  second  day,  once  in  four  hours.  It  can  be  placed  to  the 
breast  more  frequently  if  it  refuses  to  nurse  or  fails  to  obtain  nourishment. 

A  good  flow  of  milk  is  frequently  not  established  until  the  fourth  or 
fifth  day,  and  at  times,  not  until  the  sixth.  During  the  meantime,  how- 
ever, even  though  the  flow  be  very  scanty,  the  infant  should  be  put  regu- 
larly to  the  breast. 

There  is  a  tendency,  especially  on  the  part  of  young  mothers,  to  give  food 
to  the  infant  during  the  time  that  the  flow  of  milk  is  being  established.  This 
often  leads  to  most  unfortunate  results  and  frequently  to  serious  illness. 
Nothing  should  be  given  aside  from  the  mother's  milk  except  a  little  pure 
water  or  a  clean  linen  rag  moistened  with  pure  water  to  suck. 

After  the  third  day,  during  the  first  month  or  five  weeks,  ten  nursings  in 
twenty -four  hours  will  be  sufficient  for  the  normal  infant  and  no  more  should 
be  allowed.  A  healthy  child  will  usually,  during  the  first  month,  take  one 
long  nap  of  from  four  to  six  hours  each  day.  It  should  not  be  wakened 
for  feeding  during  this  nap,  but  aside  from  this  should  be  fed  regularly 
every  two  hours.  Do  not  feed  more  often. 

From  the  sixth  week  to  the  third  month  eight  nursings,  two  and  a  half 
hours  apart,  will  be  sufficient,  with  one  nursing  at  night.  From  the  third 
to  the  fifth  month,  the  baby  should  be  nursed  every  three  hours  during 
the  day  time. 

Nurse  at  regular  intervals.  Don't  nurse  too  often.  Don't  put  the  baby 
to  the  breast  every  time  it  cries.  Babies  more  frequently  suffer  from  over- 
feeding than  underfeeding.  If  you  nurse  too  often,  your  milk  will  become 
unfit  for  your  baby. 

It  is  easy  to  get  a  baby  into  good  habits.  It  is  hard  to  get  a  baby  out  of 
bad  habits.  By  adopting  regular  habits  of  nursing,  the  mother  is  given 
more  freedom  and  more  rest  and  is  in  better  condition  to  take  good  care  of 
her  child. 

The  nursing  should  not  last  over  20  minutes.  Never  let  the  baby  go 
to  sleep  with  the  nipple  in  its  mouth. 

It  is  much  better  to  use  one  breast  for  each  feeding,  alternating  regular- 
ly, than  to  let  the  baby  nurse  at  both  breasts  at  each  feeding.  It  is  a  good 
plan  to  keep  a  memorandum  slip  of  paper  arranged  as  follows  so  that  the 
breasts  are  used  equally: 

Right,  5  a.  m.;  left,  7;  right,  9;  left,  11;  right,  1  p.  m.;  left,  3;  right,  5; 
left,  7:  right,  9. 

Crying  during  the  first  few  days  of  life  is  perfectly  natural  and  even  bene- 
ficial to  the  child.  It  does  not  indicate  illness  or  hunger  and  medicines  or 
foods  should  not  be  given. 


Never  give  a  baby  drugs  or  medicines  except  under  the  direction  of  a 
physician.  What  benefited  your  neighbor's  baby  may  kill  yours. 

If  your  baby  shows  signs  of  colic  don't  dose  it  with  paregoric,  whiskey, 
brandy  or  soothing  syrup.  Colic  is  often  a  symptom  of  some  condition  which 
needs  attention.  Drugging  the  baby  into  insensibility  will  not  remove  the 
cause  of  illness.  Colic  is  often  due  to  constipation.  It  may  come  from  cold 
hands  and  feet.  Keep  the  baby's  hands  and  feet  warm.  Give  a  little  castor 
oil  for  the  constipation.  Keep  a  flannel  belly  band  on  the  baby  summer  and 
winter.  Don't  drug  the  baby.  When  the  baby  is  sick  enough  to  need  sooth- 
ing syrup,  it  is  sick  enough  to  need  a  doctor.  Soothing  syrups  have  killed 
many  babies. 

The  majority  of  so-called  "Soothing  Syrups"  contain  opium,  a  deadly  poi- 
son, one  especially  deadly  to  infants.  As  stated,  soothing  syrups  have  killed 
many  babies. 

"MRS.  WINSLOW'S  SOOTHING  SYRUP"*  is  a  preparation  with  which 
helpless  infants  have  been  drugged  into  insensibility  by  ignorant  or  indif- 
ferent mothers  and  nurses  for  a  generation  past.  This  contains  opium. 
There  is  little  doubt  but  that  this  nostrum  has  done  incalculable  injury  to 
many  children,  to  say  nothing  of  the  deaths  caused  by  it. 

The  great  demand  for  soothing  syrups  by  mothers  who  wish  their  babies 
to  "stay  put"  has  -caused  the  birth  of  a  healthy  rival  to  the  product  of  the 
late  "Mrs.  Winslow,"  a  compound  bearing  the  touching  name  of  KOPP'S 
BABY  f  FRIEND."  This  also  contains  opium!  In  fact,  Collier's 
Weekly,  to  which  much  credit  is  due  for  its  expose  of  the  nostrums 
which  are  such  a  menace  to  the  lives  and  health  of  the  American  people, 
states  that  the  preparation  is  made  of  sweetened  water  and  morphine — the 
active  principle  of  opium.  Morphine  should  not  be  given  to  a  child  under 
ten  years  of  age,  except  in  rare  instances,  and  then  only  under  the  direction 
of  a  physician.  KOPP'S  BABY  FRIEND,  well  styled  the  "King  of  Baby 
Soothers,"  is  said  to  contain  in  each  teaspoonful  sufficent  morphine  to  kill 
an  infant. 

WEANINQ  THE  BABY. 

Few  mothers  are  able  to  nurse  their  infants  after  the  ninth  month  with- 
out too  much  of  a  drain  upon  themselves  and  injury  to  the  child.  Many 
women  should  wean  their  infants  at  six  months.  There  is  grave  danger  to 
the  child  in  nursing  too  long. 

Weaning  should  be  done  gradually.  Sudden  weaning  is  apt  to  cause  seri- 
ous illness  of  the  infant.  It  is  usually  best  not  to  wean  the  baby  in  hot 
weather. 

During  the  fifth  or  sixth  month  the  infant  may  be  taught  to  take  food 
and  water  from  the  bottle.  This  will  help  materially  in  weaning. 

In  changing  from  breast  milk  to  cows  milk,  the  milk  used  first  should  be 
very  much  diluted  and  modified  unless  the  baby  has  been  given-a  bottle  in 
addition  to  the  mother's  milk.  In  weaning  a  six  months  old  baby  give  the  milk 
usually  given  to  an  infant  one  month  old  (See  page  13).  If  the  baby  is  ten 
months  old,  give  the  milk  usually  given  to  a  three  months  old  baby.  (See 
page  13). 

It  is  well  to  begin  weaning  early,  feeding  the  infant  for  some  time  with 
both  breast  milk  and  artificial  food. 

*Some  years  aRO  I  heard  a  prominent  New  York  lawyer,  asked  bv  his  office  scrub-woman 
to  buy  a  ticket  for  some  "Association"  ball,  say  to  her:  'How  can  you  go  to  these  affairs,  Nora, 
when  you  have  two  young  children  at  home?' 

"Sure,  they're  all  right",  she  returned  blithely;  just  wan  teaspoonful  of  Wmslow  s,  an 
they  lay  like  the  dead  till  mornin'."— Collier's  Weekly. 


WHEN  TO  ADOPT  ARTIFICIAL  FEEDING. 

Artificial  feeding  should  be  adopted  when  the  mother  is  unable  to  nurse; 
when  the  infant  is  unable  to  nurse,  when  the  milk  continues  to  disagree 
with  the  infant,  when  the  milk  supply  remains  insufficient,  when  the  health 
of  the  infant  or  mother  calls  for  weaning,  when  the  milk  does  not  contain 
sufficient  nourishment  for  the  baby. 

When  the  milk  is  good  in  quality  but  insufficient  in  quantity  it  is  better 
bo  "help  the  mother  out"  by  giving  the  baby  some  artificial  food  in  addi- 
tion to  the  breast  milk.  This  should  also  be  done  at  the  beginning  of 
weaning. 

Good  artificial  feeding  is  better  than  bad  breast  feeding. 

Breast  feeding  should  invariably  be  discontinued  under  the  following  con- 
ditions: 

1.  When  the  mother  is  a  consumptive.    Not  only  is  there  danger  to  the 
child  in  nursing  at  the  breast  of  the  consumptive  mother,  but  the  drain 
upon  the  mother  herself  hastens  the  progress  and  fatal  termination  of  the 
disease. 

2.  When  serious  complications  follow  child-birth,  such  as  severe  hemor- 
rhage, child-bed  fever,  blood  poisoning  or  kidney  disease. 

3.  When  the  mother  is  epileptic  or  suffers  from  St.  Vitus'  dance  or  is  so 
intensely  nervous  as  to  require  medical  attention. 

4.  When  the  mother  suffers  from  any  chronic  disease  or  is  very  delicate. 
Nursing  under  such  conditions  is  too  severe  a  drain  upon  the  mother  and 
usually  unsatisfactory  for  the  child. 

5.  When  the  mother  has  become  again  pregnant. 

Briefly,  when  the  mother  is  not  diseased  and  the  milk  is  merely  deficient 
in  quantity  or  quality,  it  is  better  for  the  child  to  have  both  breast  milk 
and  artificial  food.  When  the  mother  suffers  from  disease  which  impairs 
the  healthfulness  of  the  milk,  artificial  food  alone  must  be  adopted. 

Extreme  sensitiveness  of  the  breasts,  even  though  there  may  be  intense 
pain  in  nursing,  is  not  a  valid  reason  for  discontinuing  nursing.  Persist 
ence  for  a  few  days  usually  overcomes  this  sensitiveness. 

Menstruation  of  the  mother  does  not  affect  the  milk  as  much  as  usually 
believed.  It  may  at  times,  however,  cause  slight  indigestion  but  is  not  a 
sound  reason  for  discontinuing  nursing. 

The  nursing  mother  can  become  pregnant,  the  oft  expressed  opinions  to 
the  contrary  notwithstanding.  It  is  necessary  to  emphasize  this  fact,  for 
it  is  well  known  that  some  mothers  nurse  their  children  for  several  months 
after  they  should  be  weaned  in  the  belief  that  they  cannot  become  pregnant. 
Could  these  misguided  mothers  hear  the  experiences  of  those  who  have  used 
this  method  of  prevention  (?),  they  would  soon  abandon  their  folly  and 
cease  to  give  to  their  helpless  infants  a  milk  deficient  in  quality,  the  admin- 
istration of  which  may  work  irreparable  injury. 

ARTIFICIAL  FEEDING. 

When  it  has  been  shown  that  artificial  feeding  must  be  adopted  we  must 
select  that  food  which  is  best  for  the  child  and  which  gives  best  promise  of 
healthful  development.  In  this  selection  we  must  decide  between  the  milk 
of  another  nursing  woman — the  wet-nurse — the  milk  of  the  cow  and  the 
manufactured  infant  foods. 

Whatever  food  may  be  selected  it  must  be  remembered  that  even  a  little 
breast  milk  each  day  will  improve  the  infant's  chances  of  life  and  health. 


The  baby  who  can  have  breast  milk  in  addition  to  the  artificial  food  will  do 
better  than  if  dependent  upon  artificial  food  alone.  If  possible  put  the  baby 
to  the  breast  if  no  oftener  than  thrice  a  day. 

WET  NURSES.  The  wet  nurse  is  by  no  means  as  popular  as  in  years 
past.  While  the  milk  of  another  woman  is  the  ideal  substitute  for  the  infant 
deprived  of  its  mother's  milk,  there  are  many  objections  to  the  wet-nurse. 
The  expense  of  keeping  a  wet  nurse  is  considerable.  The  pay  is  high  and 
the  cost  of  keeping  another  adult  in  the  family  is  not  trifling.  The  wet- 
nurse  coming  from  humble  walks  in  life  may  be  a  good  nurse  under  her 
normal  conditions.  When  she  enters  a  home  where  she  is  given  richer  food 
and  lives  a  life  of  laziness,  her  milk  often  becomes  unsuited  to  the  child. 
To  be  satisfactory  a  wet-nurse  should  live  as  nearly  as  possible  in  the  man- 
ner in  which  she  has  been  accustomed. 

In  hiring  a  wet-nurse  remember  that  we  are  entrusting  the  infant  to  a 
source  of  food  which  may  be  lost  at  any  time.  The  baby  is  dependent  upon 
the  whims  and  caprices  of  the  wet-nurse,  who  may  leave  at  any  moment 
without  warning. 

Unless  the  nurse  is  perfectly  healthy  the  child  may  acquire  disease  from 
her.  A  wet-nurse  should  never  be  hired  unless  she  has  been  thoroughly  ex- 
amined by  the  family  physician. 

Civilized  people  cannot  ignore  the  fact  that  many  babies  whose  mothers 
secure  employment  as  wet  nurses,  die  from  neglect.  A  wet  nurse  should 
never  be  employed  if  her  own  baby  will  suffer  through  her  employment. 
The  nervous  influences  connected  with  the  parting  from  her  own  child,  often 
affect  the  milk  of  the  wet  nurse. 

COW'S  MILK. 

Cow's  milk  and  mother's  milk  differ  in  many  essential  particulars.  One 
is  suited  for  the  stomach  of  the  calf,  the  other  for  the  stomach  of  the  baby. 
As  has  been  aptly  stated,  the  milk  of  every  animal  has  certain  pecularities 
which  fit  it  for  the  stomach  of  that  particular  animal  only. 

Certain  changes  take  place  in  the  milk  of  the  cow,  immediately  after  it  is 
drawn.  These  continue,  so  that  when  the  milk  is  twenty-four  hours  old, 
the  differences  between  it  and  the  milk  of  the  mother  have  materially  in- 
creased. 

Cow's  milk  undiluted  and  unaltered  is  entirely  unfit  for  the  infant.  If 
properly  diluted  and  mixed,  however,  cow's  milk  is  the  best  substitute  for 
mother's  milk. 

Cow's  milk  can  be  diluted  best  by  either  water  or  decoctions  of  cereals, 
barley  or  oatmeal,  or  by  beef  or  mutton  broth — the  latter  towards  the  end 
of  the  first  year.  Oatmeal  and  beef  broth  have  a  tendency  to  loosen  the 
bowels. 

For  infant  feeding,  milk  must  be  fresh  and  must  come  from  dairies  that 
are  known  to  be  absolutely  clean.  Not  over  twenty-four  hours  should 
elapse  between  the  cow  and  the  baby.  Milk  over  twenty-four  hours  old 
cannot  safely  be  used  for  infants. 

The  fresher  the  milk,  the  more  easily  it  is  digested  by  the  infant. 

Milk  bottled  at  the  dairy  and  delivered  in  glass  is  purer  and  better  than 
that  delivered  in  the  milkman's  can.  Milk  bought  from  the  grocer  and 
dipped  from  cans  is  nearly  always  dirty  and  unfit  for  use. 

The  milk  should  come  from  cows  that  are  healthy  and  from  those  that 
feed  on  good  grains  and  grass.  Milk  from  herds  fed  on  wet  malt,  brewery 
grain  or  slops,  should  never  be  used. 


Common  breeds  of  cows  give  better  milk  than  Jerseys,  Aldemeys,  and 
other  finer  breeds.  The  finer  breeds  are  more  subject  to  sickness  and  dis- 
ease. 

Milk  from  a  herd  is  better  than  milk  from  one  cow.  Diseases  of  cows  are 
frequent.  If  a  cow  is  diseased,  the  baby  taking  the  milk  of  that  cow  is  apt 
to  acquire  disease.  If  that  cow  be  of  a  herd  from  which  the  baby  receives 
its  milk,  the  danger  is  reduced  to  the  minimum.  Then  the  milk  from  a 
herd  differs  less  from  day  to  day. 

Cleanliness  is  more  important  than  the  richness  of  the  milk.  It  is  better 
for  an  infant  to  have  clean  milk  in  filthy  surroundings  than  dirty  milk  in 
ideal  surroundings.  The  child  may  starve  on  poor  milk,  but  it  is  poisoned 
by  dirty  milk.  One  reason  that  breast  milk  agrees  with  infants  is  because 
it  is  perfectly  clean  when  it  enters  the  baby's  mouth. 

Milk  will  absorb  disease  and  poisonous  gases.  One  bottle  of  tainted  milk 
may  be  fatal  to  the  infant. 

The  essential  conditions  to  be  fulfilled  in  cow's  milk  which  is  to  be  used 
as  a  food  for  infants  are,  as  follows:  (1)  Freshness:  the  milk  should  not  be 
over  twenty-four  hours  old.  (2)  It  should  contain  no  preservatives.  (3)  It 
should  be  from  healthy  animals,  free  from  tuberculosis  and  other  diseases. 
(4)  It  should  be  clean.  (5)  It  should  not  be  skimmed  or  otherwise  falsified. 
(6)  It  should  contain  no  disease  germs.  (7)  It  should  be  from  a  mixed  herd 
so  that  the  milk  will  be  uniform  from  day  to  day.  (8)  It  should  be  from 
common  or  "grade"  cows  because  they  are  more  hardy,  less  subject  to  dis- 
ease, and  less  susceptible  to  influences  which  affect  the  milk. 

Don't  use  preservatives  in  milk.  Don't  buy  milk  from  a  dealer  who  uses 
preservatives.  You  can  never  tell  just  how  much  he  has  used,  or  how  much 
has  been  used  before  the  milk  reached  him,  by  the  dairyman,  the  whole- 
saler or  commission  man.  A  preservative  which  may  be  harmless  to  an  in- 
fant in  minute  quantities,  just  sufficient  to  preserve  the  milk,  may  be  a 
deadly  poison  if  used  in  large  quantities.  Boric  acid,  borax,  formaldehyde 
and  bicarbonate  of  soda  are  commonly  used  to  prevent  milk  from  "turn- 
ing." Health  officials  or  your  physician  will  be  able  to  detect  preservatives 
in  milk.  If  in  doubt  refer  samples. to  them.* 

The  honest  and  intelligent  dairyman  or  milk-dealer  is  of  the  greatest  aid 
in  saving  the  lives  of  babies.  He  should  receive  your  support  and  encour- 
agement. 

Don't  buy  cheap  milk.  Poor  milk  is  dear  at  any  price.  Good  milk  is  not 
dear  at  the  prevailing  prices.  A  good,  clean,  fresh  milk  at  six  or  seven 
cents  a  quart  is  very  reasonable— a  first  class  milk  at  eight  or  nine  cents  a 
quart  is  not  high  when  one  considers  the  price  of  other  commodities  If 
you  must  economize  on  your  baby  do  so  on  its  clothing,  not  on  its  food. 

It  is  amusing  and  yet  pathetic  to  see  a  parent  haggle  over  the  price  of 
the  infant's  food,  endeavoring  to  save  a  fraction  of  a  cent  on  a  glassful,  and 
then  willingly  spend  the  price  of  a  quart  or  two  on  soda  water  or  beer. 
"SCALDING,"  STERILIZING  AND  PASTEURIZING  MILK. 

Good  fresh  milk  which  has  been  kept  clean  and  cold,  needs  no  preserva- 
tive. It  is  better  to  neither  "scald,"  sterilize  nor  Pasteurize  such  milk. 

In  many  instances,  however,  the  milk  which  the  mother  must  give  her 
infant  is  neither  good  nor  fresh.  It  has  not  been  kept  clean  or  cold.  It 
sours  quickly.  It  is  imperative  that  steps  be  taken  to  render  such  milk  as 
harmless  as  possible  to  the  infant  and  to  keep  it  from  spoiling.  This  is  best 
done  by  heating  the  milk,  by  either  "scalding,"  sterilizing  or  Pasteurizing: 

'Information  as  to  reliable  tests  for  preservatives  in  milk  will  be  forwarded  by  the  State 
Board  of  Health  on  the  application  of  any  physician  or  health  officer. 


9 

Sterilization  is  the  heating  of  milk  at  a  temperature  of  212°  F.  for  some 
time.  This  renders  the  milk  harder  to  digest  and  decreases  its  food  value. 
It  causes  several  changes  in  the  properties  of  the  milk. 

Between  dirty  milk  and  cooked  milk,  however,  we  must  choose  of  two 
evils.  Sterilization  or  cooking  is  the  lesser  of  the  two. 

If  it  is  necessary  to  sterilize  at  all,  the  sooner  we  sterilize  the  better.  It 
is  more  effective  if  done  at  the  dairy.  In  the  home,  milk  should  be  steril- 
ized or  scalded  as  soon  as  it  is  received. 

Sterilization  will  not  purify  dirty  milk.  Dirty  sterilized  milk  may  be  poi- 
sonous to  the  infant. 

Pasteurization  is  a  complicated  process.  Bad  results  may  follow  if  not  done 
properly.  Sterilization  renders  the  milk  safer  and  better,  especially  where 
ice  is  not  to  be  had.  Among  the  poor  in  larger  cities,  sterilization  is  the  only 
proper  method  of  preserving  milk. 

The  use  of  any  cooked  milk  for  a  long  period  of  time — whether  scalded, 
sterilized  or  Pasteurized— is  attended  with  grave  risk.  The  infant  depend- 
ent upon  cooked  milk  will  not  thrive  so  well  as  the  one  fed  on  clean,  fresh 
milk,  and  must  consequently  be  watched  with  great  care. 

The  simplest  way  to  scald  or  sterilize  milk  is  to  put  it  in  a  double  boiler 
or  in  a  vessel  in  a  pan  of  cold  water.  Put  it  on  the  stove.  When  the  water 
has  come  to  a  boil,  remove  the  boiler  from  the  stove.  Permit  the  milk  to 
remain  in  the  water  for  about  20  minutes  and  cool  as  quickly  as  possible. 
Put  it  in  a  fruit  jar  which  has  been  previously  scalded.  Keep  the  cap  screwed 
on  the  bottle  constantly.  The  cap,  as  well  as  the  bottle,  must  be  scalded. 

In  scalding  milk,  do  not  let  the  milk  boil. 

Everything  which  comes  .in  contact  with  the  scalded  milk  must  be  scru- 
pulously clean.  It  is  as  easy  to  get  sterilized  milk  dirty  as  fresh  milk. 

In  many  cities  "certified  milk"  may  be  secured  at  a  little  higher  price 
than  ordinary  milk.  The  additional  cost  is  well  invested.  Such  milk  is  us- 
ually pure  and  clean,  from  herds  of  healthy  cattle  and  is  made  to  contain 
the  same  amount  of  cream  summer  and  winter, 

There  is  ho  milk  so  pure  and  so  good  that  it  is  suited  to  the  digestion  of 
the  infant  without  dilution  and  modification. 

CONDENSED  MILK. 

Condensed  milk  is  the  artificial  food  most  commonly  used,  especially 
among  the  poor.  Babies  fed  on  condensed  milk  alone  are  often  fat,. but  sel- 
dom strong,  A  fat  baby  is  not  always  a  healthy  baby. 

Condensed  milk  is  easily  digested  even  by  very  young  and  frail  infants. 
Its  effects  are  not  satisfactory.  It  may  serve  a  good  purpose  in  time  of  em- 
ergency when  pure,  reliable  milk  cannot  be  secured.  Between  dirty,  impure 
or  stale  cow's  milk  and  condensed  milk,  choose  the  condensed  milk,  but  it 
must  not  be  used  for  any  length  of  time.  When  traveling  or  when  the  milk 
supply  fails,  condensed  milk  often  tides  the  infant  over  a  period  of  danger. 

Condensed  milk  contains  too  much  sugar  and  not  enough  fat.  Practically 
every  baby  raised  on  it  alone  shows  signs  of  rickets  or  other  disease.  It 
should  never  be  given  without  the  addition  of  fats;  fresh  cream  if  possible. 
Iri  the  absence  of  fresh  cream,  cod  liver  oil  may  be  given,  5  to  20  drops  at  each 
feeding. 

If  you  use  condensed  milk  get  the  best  that  can  be  had.  Borden's  Eagle 
Brand  and  the  Helvetia  Brand  are  known  to  be  well  prepared  and  reliable. 


10 


MANUFACTURED  FOODS. 

There  are  many  infant  foods  on  the  market.  Their  use  is  decried  by  some 
eminent  authorities  on  infant  feeding.  It  is  claimed  that  they  can  do  much 
harm;  that  certain  diseases  have  followed  their  prolonged  use.  Other  em- 
inent authorities  assert  that  these  foods  may  be  of  considerable  value.  Still 
other  authorities,  equally  as  eminent,  advocate  the  use  of  some  of  these 
foods,  and  hold  that  they  may  be  advantageously  used  as  an  addition  to 
mothers  milk,  especially  after  the  fifth  and  sixth  month. 

The  most  commonly  used  foods  are  classified  as  Milk  Foods,  Malted  Foods 
and  Farinaceous  Foods.  Horlick's,  Borden's  (malted  milk)  and  Mellin's  are 
examples  of  the  second  class,  and  Eskay's  of  the  third. 

None  of  these  foods  contains  sufficient  fat.  Some  have  an  excess  of  starch, 
making  them  unsuitable  for  the  infant  until  the  latter  part  of  the  first  year. 
Some  contain  too  much  sugar.  None  of  these  foods  should  be  used  alone. 

The  manufacturers  of  Horlick's  Malted  Milk  assert  that  it  does  not  require 
the  addition  of  cow's  milk;  that  it  is  composed  of  pure,  rich  cow's  milk  re- 
duced to  dryness  and  combined  with  an  extract  of  malted  wheat  and  barley. 
The  food  may  be  used  temporarily,  alone,  but  it  is  believed  for  continued  use, 
milk  should  be  added. 

Mellin's  Food  is  said  to  be  a  dry  extract  from  wheat  and  malt,  and  free 
from  cane  sugar  and  starch. 


BREflST  MILK 


S/JLT5 


Note— The  manufactured  food  is  shown  as  mixed  with  water  alone.    Mixed  with  milk,  as 
usually  directed,  the  comparison  would  show  it  much  more  like  breast  milk. 

Eskay's  Food,  according  to  the  manufacturers,  contains  the  more  easily 
digested  cereals  combined  with  egg  albumen. 

An  analysis  of  Horlick's  Malted  Milk  shows  that  it  contains  less  fat  than 
mother's  milk  and  more  sugar,  and  that  it  is  free  from  starch.  Mellin's 
Food  has  practically  no  fats  or  starch  and  much  more  sugar  than  mother's 
milk. 


11 


Eskay's  food,  when  properly  mixed  with  milk,  resembles  breasfc  milk  very 
closely,  except  that  there  is  some  starch  present.  It  is  stated,  however, 
that  this  starch  is  thoroughly  broken  up  and  easily  digested  and  that  the 
egg  albumen  contained  is  more  easily  digested  than  similar  amounts  of  the 
albumen  or  curds  of  milk. 

The  chart  at  the  foot  of  page  10,  shows  a  comparison  of  Breast  Milk, 
Cows  Milk,  Condensed  Milk  and  a  widely  advertised  Manufactured  Food. 

Notwithstanding  the  conflicting  testimony  on  the  value  of  these  foods, 
and  the  disadvantages  of  some  for  infant  feeding,  as  indicated  above,  it  is 
well  known  that  their  use  is  recommended  by  competent  physicians  and  that 
they  are  used  to  seeming  advantage  by  many  infants. 

If  used,  they  should  not,  as  stated  above,  be  used  alone.  They  should 
be  mixed  with  diluted  cow's  milk,  in  which  it  is  believed  that  they  break 
up  the  tough  curds  and  render  the  milk  more  digestible.  The  same  ad- 
vantage, can  be  attributed  to  barley  water  and  oatmeal  water  which,  how- 
ever, do  not  contain  all  of  the  food  elements  to  be  found  in  the  best  types 
of  the  prepared  foods. 

In  using  or  adopting  the  artiflcal  foods,  as  in  all  cases  where  the  mothers' 
milk  is  to  be  discontinued,  it  is  best  to  follow  the  advice  of  a  competent 
physician. 

MILK  MODIFICATION. 

As  stated,  cow's  milk,  properly  diluted  and  modified,  is  the  best  substi- 
tute for  mother's  milk.  Undiluted  and  unmodified  it  is  unfit  for  infant 
'food.  Cow's  milk  must  be  diluted  on  account  of  its  richness  in  curds. 
When  diluted,  however,  it  contains  too  little  fats  and  sugar.  Hence,  after 
dilution,  we  must  add  cream  and  sugar  to  the  milk.  This  process  imitates 
the  milk  of  the  mother  as  nearly  as  can  be  done.  It  is  commonly  known 
as  "milk  modification."  Milk  so  treated  is  called  "modified  milk."  "Modi- 


a  b  c 

CUT  1. 

tied  milk"  is  now  accepted  by  all  authorities  as  the  best  food  for  the  infant 
deprived  of  breast  milk. 

Good  cows'  milk  contains  about  4  per  cent  of  butter  fat.  A  bottle  of 
good  milk  maybe  called  "4  per  cent  milk."  After  standing  until  the  cream 
rises  to  the  top,  the  upper  third  of  a  bottle  of  a  good  milk  contains  10  per 


12 


cent  of  butter  fat.  This  upper  third  is  called  "10  per  cent  milk"  or  cream. 
The  upper  half  of  a  bottle  of  good  milk  contains  7  per  cent  of  butter  fat 
and  this  is  known  as  "7  per  cent  milk."  When  buying  milk  for  infant 
feeding  insist  upon  having  "whole  milk,"  never  "skim  milk."  Whole  milk 
should  be  "4  per  cent  milk."  The  following  materials  are  required  for 
milk  modification. 

Water. — The  water  with  which  the  food  will  be  diluted  should  be  abso- 
lutely pure.  The  benefits  of  clean  milk  are  entirely  lost  if  we  dilute  it 
with' dirty  water. 

Lime  Water. — Lime  water  is  used  to  overcome  the  acidity  of  cow's  milk, 
and  to  lessen  the  consistency  of  the  curd.  There  are  some  infants  with 
whom  it  does  not  agree.  Used  too  freely  it  may  cause  constipation.  It  may 
be  obtained  cheaply  from  the  druggist. 

Eecent  investigations  by  pure  food  authorities  show  that  many  unscrup- 
ulous druggists  sell  ordinary,  unfiltered  tap  water  for  lime  water/ In  buying 
materials  of  any  kind  for  infant  feeding,  patronize  only  druggists  in  whom 
you  have  reason  to  have  confidence. 

Vichy  water  is  a  good  substitute  for  lime  water  and  should  be  used  if  the 
latter  disagrees. 

Sugar. — Sugar  is  not  added  to  cow's  milk  to  sweeten  it,  but  to  make  it 
conform  as  nearly  as  possible  to  mother's  milk.  Milk  sugar  is  best.  Get  it 
from  a  reliable  druggist.  If  you  can't  get  pure  milk  sugar,  use  cane  sugar. 
If  cane  sugar  is  used  add  only  half  the  quantity  that  you  would  of  milk 
sugar. 

Cane  sugar  is  seldom  adulterated  or  impure,  while  milk  sugar  often  con- 
tains impurities.  For  this  reason  it  is  safer,  unless  sure  of  the  reliability  of 
your  dealer,  to  use  cane  sugar.  Loaf  sugar  is  the  purest  form  of  sugar  and 
the  purest  of  all  foods. 

Barley  Water. — Barley  water  is  often  used  in  diluting  milk  for  infant 
feeding  and  tends  to  make  the  curds  of  milk  more  easily  digestible.  Barley 
water  is  made  as  follows:  To  2  tablespoonsful  of  barley  meal  add  enough  of 
a  quart  of  cold  water  to  make  a  thin  paste  and  then  add  the  remainder  of 
the  quart  of  water;  stir  and  boil  15  to  20  minutes.  Barley  flour  is  much  bet- 
ter than  pearl  barley  and  requires  much  less  cooking.  Pearl  barley  should  be 
boiled  for  2  to  3  hours.  Barley  water  should  not  be  kept  from  day  to  day, 
but  should  be  made  fresh  every  morning. 

Oatmeal  Water. — Oatmeal  water  is  used  in  the  same  way  as  barley  water, 
especially  when  a  laxative  effect  is  desired.  To  make  it,  stir  2  tablespoons- 
ful of  oatmeal  in  a  quart  of  boiling  water,  cover  and  let  simmer  for  2  hours. 
Replace  the  water  as  it  evaporates  so  that  there  will  be  a  quart  when  done. 
Strain.  Do  not  use  a  second  day.  Make  fresh  every  day. 

MILK  MIXTURES. 

The  upper  'third  of  a  bottle  of  milk(10  per  cent  milk),  or.  the  upper  half 
(7  per  cent  milk)  may  be  easily  taken  off  with  a  spoon  or  with  the  little  dip- 
per shown  in  Cut  II.  This  dipper  holds  just  one  ounce  and  is  convenient 

for  dipping  and  measuring.  With  it  the  up- 
per milk  may  be  removed  without  disturbing 
the  lower  milk.  It  is  known  as  the  "Chapin 
dipper"  and  may  be  had  at  the  druggist's  at  a 
small  cost.  In  using  a  spoon  it  will  be  remem- 
bered that  eight  teaspoons  are  equivalent  to  one 
ounce,  or  four  dessertspoons  or  two  tablespoons. 
During  the  first  four  weeks  the  infant  is  to 
be  fed,  as  before  stated,  every  2  hours  and  takes 
about  2  ounces  at  each  feeding.  The  food  should 
be  mixed  in  the  morning  for  the  entire  day. 
It  should  then  be  placed  in  the  nursing  bottles, 
enough  for  a  feeding  in  each  bottle,  or  should 
be  put  in  a  covered  glass  jar  and  placed  on  ice. 
For  the  first  weeks  in  life  the  baby  will  use  20 
CUT  II.  ounces  a  day.  The  following  milk  mixtures 


13 

are  based  on  that  amount.    It  is  easy  to  estimate  the  quantities  for  larger 
amounts.    For  a  25  ounce  mixture,  add  one-fourth  more  of  each  ingredient. 
For  a  30  ounce  mixture  add  one-half  more  of  each  ingredient. 
Milk  Mixtures. — (From  Birth  to  Three  or  Four  Months  of  Age.) 

1.  Milk  sugar,  1  oz.  (3  level  tablespoonsful. ) 
Lime  water,  1  oz. 

Enough  hot  water  to  make  20  ounces.    After  the  milk  sugar  is  dis- 
solved add  two  ounces  of  upper  third  milk  (10$  fat). 
This  is  a  suitable  modified  milk  for  the  infant  immediately  after  birth. 

2.  Milk  sugar,  lime  water  and  water  same  as  for  No.  1,  with  the  addition 
of  3  ounces  of  upper  third  milk. 

3.  Milk  sugar,  lime  water  and  water  as  in  No.  1,  with  the  addition  of  4 
ounces  of  upper  third  milk. 

4.  Milk  sugar,  lime  water  and  water  as  in  No.  1,  with  the  addition  of  5 
ounces  of  upper  third  milk. 

5.  Milk  sugar,  lime  water  and  water  as  in  No.  1,  with  the  addition  of  6 
ounces  of  upper  third  milk. 

6.  Milk  sugar,  lime  water  and  water  as  in  No.  1,  with  the  addition  of  7 
ounces  of  upper  third  milk. 

Ten  per  cent  milk  may  be  secured  as  shown  in  cut  la  from  the  upper  third 
of  the  bottle  of  good  4%  milk,  or  may  be  secured  by  mixing  2  parts  of  whole 
good  milk  with  1  part  of  cream. 

If  the  baby  is  artificially  fed  from  birth,  begin  with  Mixture  No.  1.  Sub- 
stitute the  succeeding  mixture  gradually  until  the  third  or  fourth  month. 
After  the  fourth  month  the  above  mixtures  are  not  strong  enough. 

In  weaning  an  older  infant  use  the  mixture  suited  to  the  age  of  the 
child  from  the  above  or  from  following  mixtures. 

Milk  Mixtures.— (From  the  Third  or  Fourth  Months  to  the  end  of  the 
Ninth  or  Tenth  Month.) 

For  these  formulas  is  used  the  upper  half  milk  as  shown  in  Cut  Ib,  or  milk 
containing  7%  fat.  This  may  be  secured  not  only  from  the  upper  half  of  the 
bottle  of  good  milk,  but  also  by  mixing  3  parts  of  good  milk  with  1  part  of 
cream. 

1.  Milk  sugar,  1  oz.  (3  level  tablespoonsful.) 
Lime  water,  1  oz. 

Enough  hot  water  to  make  20  ounces.    After  the  milk  sugar  is  dis- 
solved add  3  ounces  of  upper  half  milk. 

2.  Milk  sugar,  lime  water  and  water  as  in  No.  1,  with  the  addition  of  4 
ounces  of  upper  half  milk. 

3.  Milk  sugar,  lime  water  and  water  as  in  No.  1,  with  the  addition  of  5 
ounces  of  upper  half  milk. 

4.  Milk  sugar,  lime  water  and  water  as  in  No.  1,  with  the  addition  of  6 
ounces  of  upper  half  milk. 

5.  Milk  sugar,  lime  water  and  water  as  in  No.  1,  with  the  addition  of  7 
ounces  of  upper  half  milk. 

6.  Milk  sugar,  lime  water  and  water  as  in  No.  1,  with  the  addition  of  8 
ounces  of  upper  half  milk. 

7.  Milk  sugar,  lime  water  and  water  as  in  No.  1,  with  the  addition  of  9 
ounces  of  upper  half  milk. 

8.  Milk  sugar,  lime  water  and  water  as  in  No.  1,  with  the  addition  of  10 
ounces  of  upper  half  milk. 

9.  Milk  sugar,  i  oz. 
Lime  water,  1  oz. 

Enough  water  to  make  20  ounces.   To  this  add  12  ounces  of  upper  half 
milk. 


14 

Of  the  above  formulas,  it  is  seldom  necessary  for  the  healthy  infant  to  use 
a  mixture  of  less  strength  than  No.  5.  Nos.  1,  2,  3  and  4  are  of  value,  how- 
ever, during  temporary  disturbances  of  digestion  when  it  is  desired  to  re- 
lieve the  digestive  organs  of  as  much  work  as  possible. 

The  infant  which  can  take  Mixture  No.  9  of  the  above  formulas  without 
difficulty  is  usually  able  to  begin  on  No.  5,  of  the  following  formulas,  in 
which  whole  milk  (4^)  is  used._ 

Milk  Mixtures.— (For  the  latter  part  of  the  First  Year.) 

1.  Milk  sugar,  1  oz. 
Lime  water,  1  oz. 

Enough  hot  water  to  make  20  ounces.    After  the  milk  sugar  is  dis- 
solved add  5  ounces  of  whole  milk. 

2.  Milk  sugar,  lime  water  and  water  as  in  No.  1,  with  the  addition  of  6 
ounces  of  whole  milk. 

3.  Milk  sugar,  lime  water  and  water  as  in  No.  1,  with  the  addition  of  & 
ounces  of  whole  milk. 

4.  Milk  Sugar,  lime  water  and  water  as  in  No.  1,  with  the  addition  of  10 
ounces  of  whole  milk. 

5.  Milk  sugar,  £  oz. 
Lime  water,  1  oz. 

Enough  water  to  make  20  ounces.    To  this  add  12  ounces  of  whole  milk. 

6.  Milk  sugar,  lime  water  and  water  as  in  No.  5,  with  the  addition  of  14 
ounces  of  whole  milk. 

7.  Milk  sugar,  lime  water  and  water  as  in  No.  5,  with  the  addition  of  16 
ounces  of  whole  milk. 

For  mothers  who  do  not  get  milk  in  bottles  and  who  have  difficulty  in 
using  the  above  formulas,  the  following  excellent  mixtures  are  given.  They 
are  simply  prepared  and  prove  satisfactory  for  most  infants. 

For  a  new-born  baby,  or  one  a  month  or  two  old,  take  1  ounce  of  fresh 
milk;  3  ounces  of  water;  1  ounce  of  fresh  cream,  and  2  level  teaspoonsful  of 
milk  sugar.  This  makes  about  5  ounces.  For  20  ounces  use  four  time*  as 
much  of  each  ingredient.  This  closely  resembles  mother's  milk. 

For  older  babies,  take  2  ounces  of  fresh  milk;  2  ounces  of  water;  1  ounce 
of  fresh  cream;  2  level  teaspoonsful  of  milk  sugar  and  a  teaspoonful  of  lime 
water.  Larger  quantities  may  be  made  by  increasing  the  amounts  of  each 
ingredient  in  proper  proportion.  More  milk  and  less  water  will  be  used  as 
the  infant  increases  in  age. 

If  cream  disagrees  with  the  infant  its  use  should  be  stopped  temporarily. 
The  following  is  a  good  substitute  for  mothers'  milk  suitable  for  an  infant 
of  three  months  or  less:  Pure  milk,  cupful;  water,  2  cupsful;  sugar  of  milk, 
1  heaping  tablespoonful,  lime  water,  1  tablespoonful. 

Milk  sugar  should  always  be  dissolved  in  hot  water.  It  sours  quickly  when 
dissolved,  so  not  more  than  one  day's  supply  should  be  prepared  at  a  time. 

Barley  Water  and  Oatmeal  Water.— Barley  is  recommended  by  many  au- 
thorities as  a  proper  and  valuable  substance  for  infant  food.  One  author 
of  international  reputation,  Professor  A.  Jacobi,  of  New  York,  states  that, 
if  he  were  restricted  to  the  use  of  any  one  food  in.  addition  to  cows'  milk, 
it  would  be  barley  meal  or  oatmeal.  The  same  authority  prefers  barley 
water  to  oatmeal  water  for  steady  diet,  inasmuch  as  the  latter  tends  to  re- 
lax the  bowels. 

As  a  rule  these  cereal  waters  are  not  required  until  after  the  sixth  or 
seventh  month.  Some  young  infants,  however,  unable  to  digest  the  curds 
of  milk,  are  able  to  do  so  when  barley  water  is  added. 

For  very  young  infants  cereal  waters  and  gruels  should  not  be  used  except 
under  the  direction  of  a  physician. 

After  the  sixth  or  seventh  month,  barley  water  may  be  added  to  the 
milk  of  nearly  all  infants  with  advantage.  The  barley  water  may  take  the 


15 


place  of  the  water  used  in   dilution.    As  the   barley   water  is  added,  the 
sugar  should  be  reduced. 

When  the  infant  is  constipated,  oat-meal  water  should  be  used  in  place  of 
the  barley  water. 

A  prominent  physician  of  northern  Illinois,  who  has  been  practicing  in 
the  State  during  the  past  thirty  years,  writes  as  follows  in  a  recent  com- 
munication to  the  Secretary  of  the  State  Board  of  Health: 

"My  food,  for  babies  is  invariably  one  heaping  tablespoonful  of  pearl  (store) 
barley,  ground  in  a  coffee-mill,  and  boiled  in  one  quart  of  water,  down  to  a 
pint.  Strain,  and  add  the  same  quantity  of  milk,  and  let  the  baby  have  it. 
Hundreds  of  mothers  have  used  this  preparation  on  my  direction,  and  the 
result  has  been  healthy,  growing,  fat  babies.  I  think  that  Professor  Jacobi 
recommended  this  thirty  years  ago,  and  I  always  use  it,  and  with  constant 
success." 

In  connection  with  the  above  it  is  deemed  proper  to  state  here  that  many 
physicians  who  have  devoted  much  time  to  the  study  of  the  care  of  infants, 
hold  that  barley  water  or  oat-meal  water,  should  not  be  given  to  infants  un- 
til after  they  are  six  months,  and  when  given  should  be  in  the  same  quan~ 
tity  as  the  water  recommended  for  dilution  of  the  milk. 

The  infant  should  be  fed  from  a  nursing  bottle,  not  from  a  spoon  or  cup. 
The  act  of  sucking  is  necessary  to  insure  a  proper  digestion  of  the  food. 

MATERIALS  REQUIRED   FOR  MILK  MIXING. 
For  properly  preparing  milk  for  the  baby,  you  should  have: 

One  8-ounce  glass  graduate; 
Use  this.       One  glass  funnel; 

One  cream  dipper  (see  cut  II); 
A  bottle  of  lime  water; 
A  supply  of  absolutely  pure  water; 

Ten  nursing  bottles  which  can  be  easily  cleaned  (see  cut  III); 
Three  black  rubber  nipples; 

Three  bottle  brushes  for  washing  out  the  bottles. 
Pitchers,  cups,  spoons  and  measures  used  in  mixing  the  baby's 
food  should  not  be  used  for  any  other  purpose. 


As  far  as  is  possible,  the  utensils 
used  in  preparing  the  baby's  food 
should  be  of  glass,  china,  porcelain  or 
granite  iron  ware,  which  will  not  rust\ 
or  present  crevices  for  the  accumu- 
lation of  dirt.  Vessels  or  utensils 
which  are  cracked  or  present  rough 
[edges  or  surfaces  should  not  be  used. 
The  nursing  bottles  should  be  free 
'  from  angles  so  that  they  may  be  easily 
cleaned.  The  best  bottles  are  marked 
with  the  ounces  so  that  the  exact 
amount  given  may  be  easily  decided.  Square  or 
paneled  bottles  should  never  be  used.  Sour  milk 
and  dirt  cannot  be  removed  from  the  corners. 
This  tilth  remaining  will  spoil  the  milk  later  put 
in  the  bottle.  Spoiled  milk  is  a  poison  to  the  child. 
(See  Cut  IV.) 

Ten  bottles   are   recommended   as   it   is  found 
much  more  convenient   to  mix  the  food  for  the 


Do  not  use  this. 


Cut  III 


CUT 


16 


entire  day  in  the  morning  and  to  put  it  in  bottles,  enough  for  each  feeding, 
and  then  to  place  the  bottles  on  Ice.  The  food  may  be  heated  by  placing 
the  bottles  in  hot  water.  Fewer  bottles  may  be  used,  but  no  mother  should 
attempt  to  get  along  with  less  than  two. 

Nipples  of  black  rubber  are  better  than  those  of  white  or  red.  Nipples 
should  be  made  so  that  they  can  be  turned  and  washed  inside  and  out. 

Nursing  tubes  cannot  be  too  strongly  condemned. — They  cannot  be  cleaned 
and  milk  taken  through  them,  especially  in  hot  weather,  becomes  filthy  and 
is  absolutely  poisonous  to  the  infant.  (See  Cut  IV.) 

Care  of  Bottles  and  Nipples. — After  using,  bottles  should  be 
thoroughly  rinsed,  washed  in  soap-suds  and  again  rinsed.  When  not  in  use 
they  should  be  filled  with  a  solution  of  boric  acid,  a  teaspoonful  to  the  pint 
of  water.  Before  using  again  they  should  be  placed  in  boiling  water  for  10 
minutes.  Milk  should  not  be  permitted  so  remain  in  the  bottles  after  the 
baby  is  through  feeding. 

It  is  better  to  have  plenty  of  bottles  so  that  the  same  bottle  will  not  have 
to  be  used  too  frequently. 

Nipples  should  be  washed  thoroughly  inside  and 
out  after  each  nursing.  They  should  be  kept  in 
boric  acid  solution,  a  teaspoonful  to  a  pint  of  water, 
when  not  in  use. 

"Sore  mouth,"  "colic"  and  summer  complaint 
often  come  from  improper  care  of  bottles  and  nip- 
ples. A  baby  cannot  get  clean  milk  out  of  a  dirty 
bottle  or  through  a  dirty  nipple.  Absolute  cleanli- 
ness is  the  most  important  thing  in  infant  feeding. 
THE  "MATERNA  MEASURE.  "—A  simple  meth- 
od of  milk  mixing  in  the  home  is  with  the  "Ma- 
terna  Measure"  (Cut  V.)  This  is  a  16-ounce 
measure  with  six  paneled  sides.  On  each  is  marked 
the  exact  amounts  of  sugar,  lime  water,  water,  milk 
and  cream  to  be  used  in  feeding.  The  six  panels 
are  arranged  to  measure  milk  suitable  to  six  ages 
of  infancy.  The  measure  may  be  had  for  a  small 
sum  from  the  druggist  or  instrument  house.  The 
method  is  simple  and  with  it  mistakes  are  seldom 
made. 


CUT  V. 


FEEDING  THE  BABY. 


Don't  taste  the  baby's  food  by  putting  the  nipple  in  your  mouth. 

Begin  with  a  weak  food.  (See  Mixture  1,  first  set  of  Milk  Mixtures,  page 
13.)  Too  rich  food  at  the  beginning  may  make  later  feeding  difficult.  Too 
much  food  or  too  rich  food  will  upset  the  baby's  digestion  and  may  lead  to 
serious  illness. 

Increase  the  strength  of  the  food  gradually.  Overfeeding  causes  more 
sickness  than  not  enough  food. 

See  that  everything  that  comes  in  contact  with  the  milk  is  absolutely  clean. 

Keep  the  food  cold  until  ready  to  use  it.  Then  warm  it  to  about  blood 
heat.  Do  not  give  the  baby  cold  milk.  Do  not  give  the  baby  hot  milk. 

Give  just  enough  food  for  a  single  feeding.  If  any  is  left  in  the  bottle, 
throw  it  out.  Do  not  offer  the  same  milk  to  the  baby  a  second  time. 

Feed  the  baby  regularly.  If  you  start  right  the  baby  will  be  ready  for 
each  feeding  and  will  not'cry  for  food  between  feedings.  '  Kegularly  fed',  the 
baby  is  healthier  and  happier. 


17 

TABLE  OF   TIMES  AND  AMOUNTS  FOR  INFANT  FEEDING  FOR   THE 

FIRST    YEAR. 


AGE 

Hours 
between 
feeding. 

Number  of 
feedings 
between 
10  p.  m.  and 
7  a.  m. 

Number  of 
feedings  in 
24  hours. 

Ounces 
to  each 
feeding. 

Ounces  in 
24  hours. 

3rd  to  7th  day  

2 

2 

10 

\-\Ys 

10-15 

2nd  to  3rd  week  .   . 

2 

2 

10 

l%-3 

15-30 

4th  to  5th  week  

2 

1 

10 

2%-3% 

25-35  ' 

6th  week  to  3rd  month  

2% 

1 

8 

3-5 

25-40 

3rd  to  5th  month  

3 

1 

7 

4-6 

28-42 

5th  to  9th  month   

3 

0 

6 

5-7H 

30-45 

9th  to  12th  month  

4 

0 

5 

7-9 

35-45 

In  increasing  the  quantity  of  food  never  increase  more  than  a  half-ounce 
at  a  time. 

Do  not  increase  the  quantity  and  richness  of  the  food  at  the  same  time. 

Don't  feed  more  often  than  suggested  .above.  The  stomach  needs  some 
rest. 

Large  babies  require  more  food  than  small  babies. 

The  weight  is  the  best  indication  of  the  success  of  feeding.  After  the  sec- 
ond week  the  baby's  weight  should  increase  regularly.  Loss  of  weight  is  a 
danger  signal  that  must  not  be  ignored. 

The  character  of  the  stools  is  an  important  guide  in  infant  feeding.  Foul 
smelling,  greenish  or  frothy  stools  indicate  illness.  Diarrhea  is  often  the 
forerunner  of  fatal  sickness.  When  the  stools  are  unnatural  in  character 
or  when  there  are  more  than  four  movements  a  day  a  physician  should  be 
called.  Neglect  of  the  first  symptoms  of  indigestion  may  lead  to  the  serious 
illness  or  death  of  the  child. 

Never  give  patent  medicines,  drugs  or  nostrums  for  indigestion.  As  a 
rule  drugs  are  not  needed;  often  they  are  dangerous.  Proper  feeding  will 
usually  overcome  the  trouble.  In  correcting  errors  in  feeding,  the  physi- 
cian is  your  best  adviser. 

OTHER  FOODS  FOR  THE  FIRST  YEAR. 

No  other  food  than  milk  should  be  given  until  the  end  of  the  sixth  or 
seventh  month  except  on  order  of  a  physician.  Even  after  the  seventh 
month,  other  foods  should  be  given  sparingly  and  judiciously.  The  chief 
secret  of  successful  infant  feeding  lies  in  keeping  the  child  largely  on  milk 
until  well  into  the  second  year.  There  is  far  less  necessity  for  a  mixed  diet 
or  ordinary  foods  than  is  generally  supposed. 

After  the  seventh  month  gruel  made  of  barley,  arrowroot,  or  oatmeal 
may  be  given,  beginning  with  very  small  quantities.  Four  ounces  of  thick, 
strained  oatmeal  and  one-half  ounce  of  orange  juice  may  be  added  to  the 
daily  allowance  of  food. 

The  quantity  of  gruel  may  be  increased  gradually  as  the  child  becomes 
older. 


18 

Pure,  whole  milk  may  be  allowed  in  some  cases  after  the  ninth  month. 
At  about  the  same  time  the  child  may  have  a  crust  of  bread  or  a  small 
piece  of  zwiebach. 

Beef,  mutton  or  chicken  broth,  thoroughly  strained,  may  be  substituted 
for  or  added  to  the  food  after  the  tenth  month.  Soups  and  broths  for  in- 
fants should  be  very  carefully  prepared,  should  be  free  from  excess  of  fat 
or  bits  of  meat  and  should  be  very  sparingly  seasoned. 

The  cutting  of  the  eight  incisor  or  front  teeth,  which  occurs  usually  dur- 
ing the  twelfth  month,  may  be  taken  as  Nature's  indication  that  the  child 
requires  other  food  than  milk.  At  this  time,  if  the  infant  is  well  and 
strong,  a  little  stale  bread  may  be  given  with  fresh  milk  in  place  of  one  of 
the  regular  feedings.  This  may  soon  be  supplemented  by  a  small  quantity 
of  well  cooked  hominy,  oatmeal  or  corn  meal  mush,  given  with  constant 
consideration  of  the  fact  that  these  are  the  less  important  and  milk  the 
most  important  of  the  articles  of  food. 

Stale  bread  liberally  butter  satisfies  the  infant's  desire  for  solid  foo'd  and 
affords  it  an  easily  digested  and  nourishing  form  of  fat,  after  it  is  found 
that  the  foods  mentioned  above  are  taken  without  difficulty  or  bad  results. 

At  fifteen  months  a  soft  boiled  egg  may  be  given  at  the  noon  feeding. 

Fresh  beef-juice  may  be  given  in  the  latter  part  of  the  first  year  and,  at 
times,  earlier,  in  quantities  of  not  over  two  teaspoonf uls  daily. 

Beef  juice  is  best  prepared  by  broiling  a  piece  of  lean  beef  very  lightly 
and  expressing  the  juice  with  a  lemon  squeezer.  Two  or  three  ounces  can 
be  obtained  from  a  pound  of  meat. 

Beef  tea,  made  from  the  extracts  of  beef  to  be  found  upon  the  market, 
may  be  given  in  small  quantity  after  the  first  year,  but  it  must  be  remem- 
bered that  there  is  no  nutrition  in  beef  tea  and  it  must  not  be  given  in  the 
place  of  a  regular  feeding. 

Many  practioners  advise  the  use  of  these  preparations  much  earlier  than 
here  stated,  especially  if  the  milk  disagrees  or  fails  to  nourish  the  infant. 
They  are  regarded  as  especially  valuable  when  rickets  is  threatened  or 
when  the  teeth  are  slow  in  developement. 

Orange  juice  is  of  the  greatest  value  and  will  agree  perfectly  with  most 
children.  It  is. a  safe  precaution  to  give  a  half-ounce  of  orange  juice  each 
day  to  all  children  over  six-months  of  age. 

Do  not  feed  the  baby  anything  except  its  regular  food. 

Do  not  feed  the  baby  at  the  table.  Potato,  meat,  fruit,  pickles  and  all 
other  table  foods  are  absolutely  poisonous  to  the  infant.  Hundreds  of 
babies  have  been  killed  by  mistaken  parents  giving  them  such  foods. 

When  sixteen  teeth  have  developed,  other  and  more  solid  foods  may  be 
given.  Throughout  the  entire  period  of  infancy,  however,  the  food  should 
be  selected  with  the  greatest  care  and  given  moderately.  A  piece  of  rare 
roast  beef  to  suck,  bread  with  dish  gravy  (not  the  heavy  gravies  thickened 
and  highly  seasoned),  soft  boiled  or  poached  eggs,  may  form  additions  to  a 
dietary  which  may  be  extended  gradually  to  meet  requirements  as  the  baby 
develops  into  .childhood.  But  for  infant  or  for  child,  overfeeding  is  far 
more  injurious  than  underfeeding. 


19 

THE  CARE  OF  THE  BABY. 

Bathe  the  baby  every  day.  A  clean  baby  is  happier  and  healthier  than  a 
dirty  baby.  Babies  bathed  regularly  stand  the  hot  weather  better  than  those 
not  bathed.  During  the  hot  weather  it  may  be  well  to  bathe  the  baby  twice 
or  three  times  daily.  No  baby  was  ever  yet  "washed  out  of  the  world." 
Never  bathe  within  an  hour  after  feeding.  It  is  a  good  plan  to  give  the 
baby  its  bath,  then  its  bottle  and  then  a  nap. 

Take  good  care  of  baby's  skin.  If  the  skin  is  irritated  the  baby  will  be 
uncomfortable.  An  uncomfortable  baby  is  rarely  a  healthy  baby.  Use  soap 
sparingly  in  the  bath.  Never  use  it  if  the  skin  is  irritated  or  raw.  Use 
water  iri  which  a  teacupful  of  bran  tied  in  a  cheese  cloth  has  been  agitated. 
When  soap  is  used  great  care  should  be  taken  that  it  is  the  purest  kind. 

For  nettle  rash  or  prickly  heat,  add  to  the  basin  of  water  a  teaspoonful 
of  bicarbonate  of  soda  (baking  soda)  or  a  tablespoonful  of  vinegar.  After 
bathing  baby  in  summer  with  this  preparation  leave  a  slight  moisture  on 
the  skin.  -Talcum  powder  can  be  used  between  the  folds  of  flesh. 

During  the  summer  dress  the  baby  lightly.  Strip  the  baby  on  hot  days 
and  let  it  lie  around  naked  for  a  few  hours  indoors. 

Keep  the  baby  out  of  doors  as  much  as  possible,  but  avoid  the  hot  sun. 
The  baby  must  have  fresh  air.  A  few  hours  in  the  parks  every  day  or  two 
may  save  the  life  of  the  baby  living  in  crowded  city  houses. 

A  trip  to  the  country  is  often  of  great  advantage  to  a  baby  in  summer 
time.  The  lives  of  many  babies  suffering  from  "summer  complaint"  have 
been  saved  by  taking  them  to  the  country.  Of  still  greater  advantage  is  a 
trip  to  a  higher  altitude  and  to  a  cooler  climate,  in  close  proximity  to  a 
large  body  of  water. 


Even  in  the  country  a  baby  may  not  thrive  in  the  heat  of  mid-summer. 
In  such  a  case  a  change  to  a  higher  altitude  and  a  cooler  climate  is  called 
for,  especially  if  diarrhea  has  set  in.  It  may  be  the  means  of  saving  the 
baby's  life.  Too  much  stress  cannot  be  laid  on  the  advantages  of  keeping 
the  baby  close  to  water  in  the  summer.  An  ideal  location  will  be  found  in 
a  heavily  wooded  region  on  the  banks  of  a  lake  or  bay.  Too  much  sunshine 
will  do  the  baby  harm.  Natural  shade  is  necessary  for  its  comfort. 


20 

Northern  Illinois  is  dotted  with  lakes.  Good  acommodationscan  be  found 
near  the  majority.  These  lakes  are  easily  available  to  the  mothers  in  cen- 
tral and  southern  Illinois,  who  have  sufficient  means  to  even  take  their 
babies  to  the  country.  If  they  desire  to  go  further  north,  Lake  Michigan 
and  its  contiguous  great  bays  on  the  shores  of  Michigan  and  Wisconsin  can 
be  easily  reached. 

A  trip  to  a  .northern  climate  can  now  be  made  without  any  discomfort. 
During  the  past  few  seasons  it  has  been  possible  for  a  mother  living  in  cen- 
tral-southern Illinois  to  enter  a  sleeper  at  midday,  and  be  carried  without 
change  to  far  northern  Michigan,  arriving  at  the  various  resorts  on  Grand 
Traverse  or  Little  Traverse  Bays,  in  time  for  an  early  breakfast. 

Wonders  have  been  accomplished  by  a  change  to  a  northern  climate. 
Infants  suffering  from  an  apparently  uncontrollable  summer  diarrhea  and 
seemingly  doomed  to  die,  have  rapidly  regained  health  and  strength  after 
living  a  few  days  in  the  pine  woods  bordering  on  one  of  the  bays  of  north- 
ern Michigan. 

A  simple  trip  on  Lake  Michigan,  even  of  no  greater  distance  than  the 
nearest  Michigan  shore  may  restore  a  sick  baby's  health  and  strength. 

When  traveling  with  a  sick  baby,  the  mother  should  not  depend  on  milk 
purchased  en  route.  Of  its  purity  or  source  she  knows  nothing.  She  should 
take  with  her  sufficient  foods, — cows  milk,  condensed  milk  or  one  of  the 
manufactured  foods,  to  last  the  baby  during  the  trip.  It  is  better  that  the 
food  be  mixed  before  leaving  home,  and  put  in  the  nursing  bottles  ready 
for  use  when  heated.  Sufficient  drinking  water  for  the  baby's  use  should 
also  be  taken  along. 

A  basket  for  carrying  milk  when  traveling 
may  be  found  on  the  market  at  a  moderate 
price.  This  basket  is  lined  with  metal  and 
felt  or  mineral  wool  and  contains  chambers 
for  ice  and  milk  bottles.  In  it  milk  will  be 
kept  in  practically  as  good  condition  as  in  the 
home  refrigerator.  With  this  basket  a  suffic- 
ient supply  of  milk  may  be  carried  to  supply 
the  infant  en  route  from  practically  any  Illi- 
nois point  to  the  woods  of  northern  Michigan. 
The  basket  will  also  carry  an  alcohol  stove, 
supply  of  alcohol,  extra  nipples,  brushes  and 
other  accessories  to  the  nursing  bottle. 

A  soft  flannel  belly  band  is  a  great  protection  to  the  baby.  It  will  pre- 
vent the  injurious  effects  of  sudden  changes  in  the  temperature. 

The  baby  must  not  be  permitted  to  "take  cold".  Because  the  close  prox- 
imity of  water  is  beneficial  to  a  baby  in  summer,  it  does  not  follow  that  the 
baby  can  be  plunged  into  the  water.  The  baby  should  be  bathed  in  a  room 
warmed  to  a  temperature  of  at  least  75  degrees,  and  guarded  against  draughts. 
The  temperature  of  the  water  should  not  be  less  than  80  degrees.  Much 
harm  has  been  done  by  immersing  babies  in  the  surf. 

There  will  be  no  harm  in  sponging  the  baby's  neck  and  feet  (if  over  one 
year)  with  cold  water  at  night,  and  follow  with  a  brisk  rubbing.  This  in 
many  cases  will  prevent  the  taking  of  cold. 

A  child  of  two  years  can  run  on  the  sands  in  its  bare  feet,  occasionally 
stepping  into  the  water,  but  no  surf  bathing  under  three  years. 

The  greatest  care  should  be  used  in  the  selection  of  the  baby's  diapers  at 
all  times,  and  especially  during  the  summer  months  when  it  is  so  easy  to 


21 

overheat  or  irritate  the  bladder  and  bowels.  The  diapers,  as  a  rule  should 
be  made  of  the  softest  cotton  cloth.  They  should  be  washed  with  pure  re- 
fined soap  and  after  being  thoroughly  rinsed  should  be  well  aired  and  dried. 

Diapers^  freshly  washed,  should  never  be  put  on  a  child  suffering  with 
diarrhea.  If  there  are  no  diapers  on  hand  which  have  been  washed  sev- 
eral days  previous,  then  the  mother  should  go  through  the  house  and 
gather  up  all  the  clean  soft  pieces  of  old  linen  and  muslin  she  can  find,  and 
cut  them  into  proper  shape  for  use  as  diapers.  In  summer  diarrhea  the 
ordinary  recently  washed  diaper  must  never  be  used.  The  mother  should 
use  instead  soft  pieces  of  old,  long-ago-washed,  clean  linen  or  muslin.  If 
the.  supply  in  her  own  house  is  insufficient,  let  the  mother  borrow  from 
other  mothers  who  will  be  glad  to  come  to  her  assistance.  After 
"changing"  baby  use  sweet  oil  on  the  irritated  surfaces  instead  of  powder. 

Neither  nurse  nor  mother  should  ever  put  her  fingers  into  baby's  mouth 
without  first  washing  them. 

Don't  have  the  baby  sleep  in  the  same  bed  with  an  adult.  If  there  is  no 
crib  make  a  bed  for  the  baby  on  a  couch  or  chair. 

Don't  let  the  baby  put  dogs  or  cats  close  .to  its  mouth. 

Don't  try  to  make  the  baby  walk.  It  will  walk  when  it  gets  ready.  Few 
babies  can  walk  at  twelve  months;  none  should. 

Don't  take  baby  out-of-doors  on  an  empty  stomach. 

Every  baby  requires  water  in  addition  to  its  food.  In  hot  weather  espe- 
cially give  a  drink  of  pure  water  several  times  a  day. 

A  drink  of  pure  water  or  of  thin  barley  water,  without  milk,  is  excellent 
for  a  child  of  six  months  or  more  if  it  awakes  in  the  night  and  cries  for 
food.  It  really  needs  nothing  more. 

A  few  words  in  conclusion  as  to  baby's  teething.  The  first — the  two  lower 
front  teeth — are  usually  cut  when  the  baby  is  from  six  to  seven  months  old. 
Some  babies  cut  their  teeth  with  little  trouble;  others  are  restless,  uneasy 
and  wakeful.  The  latter  is  especially  the  case  if  the  baby  be  constipated. 

The  teeth  are  usually  cut  in  pairs:  first  the  two  lower  (in  the  center),  next 
the  two  upper,  then  the  outside  two  above,  then  two  below,  next  to  those 
first  cut.  These  teeth  usually  are  present  by  the  twelfth  month.  The  cut- 
ting, however,  does  not  always  follow  the  above  order,  and  all  children  do 
not  cut  their  first  teeth  by  the  sixth  or  seventh  month. 

For  the  sleeplessness  and  irritability  which  so  often  accompany  teething, 
much  can  be  done  by  the  mother.  Drugs  should  not  be  given,  except  under 
the  direction  of  a  physician.  A  hot  foot  bath  will  often  have  a  soothing  ef- 
fect by  relieving  the  congestion  in  the  head  and  mouth.  Mustard  can  often 
be  added  to  the  foot  bath  with  benefit.  A  little  castor  oil  will  be  beneficial, 
for  a  good  movement  of  the  bowels  will  relieve  congestion  in  the  gums. 
The  mother's  finger  dipped  in  syrup  of  lettuce  can  be  gently  carried  over 
the  tender  and  inflamed  gum,  and  now  and  then  a  little  firmer  pressure  may 
allow  the  point  of  the  tooth  to  free  its  way  through.  The  baby  may  be  al- 
lowed to  bite  on  a  small  chicken  or  ham  bone,  or  if  over  nine  months,  on  a 
piece  of  rare  roast  beef. 

Beware  of  soothing  syrups  which  merely  "dope"  the  baby,  and  often  cause 
great  injury. 

Published  by  order  of  the  State  Board  of  Health. 

James  A.  Egan,  M.  D., 
April  2,  1906  Secretary. 


— 

SLOGESTIO.\S  TO  DA //?K»!E.V  A\D  MILK  DEALERS. 

The  production  of  a  good,  clean  milk  is  not  the  complicated  business  it  has 
often  been  regarded.  It  requires  only  reasonable  knowledge,  reasonable  in- 
telligence and  reasonable  care.  ' 

The  following  suggestions,  if  observed,  will  do  much  toward  securing  a 
good,  clean  milk.  Whenever  it  is  practicable  to  do  so.  milk  buyers  should 
see  that  their  dairymen  live  up  to  the  standards  at  least  this  high: 

Don't  buy  Jerseys.  Alderneys  or  other  fine  grade  cows.  If  you  have  Jer- 
seys and  Alderneys,  cross  breed  them  with  common,  hardy  stock  like  Dur- 
hams  and  Holsteins.  Common  breeds  do  not  give  as  rich  milk,  but  it  is 
more  digestible.  Common  grade  cattle  are  hardier  and  are  not  subject  to  dis- 
ease as  much  as  are  the  finer  grades. 

Have  your  cows  tuberculin  tested  to  show  that  they  are  not  afflicted  with 
tuberculosis.  Consumption  may  be  acquired  from  the  milk  of  cows  so  dis- 
eased- 
Feed  your  cows  clean,  dry  food.  Slops  and  brewer's  grains  are  unfit  foods 
for  milk  cows.  Cabbage  and  other  strong  tasting  foods  give  a  strong  taste 
to  the  milk. 

Do  not  turn  your  cows  into  fresh  pastures  too  suddenly  in  the  spring. 
Barn-fed  cows,  turned  at  once  into  unripe  grass,  give  milk  which  often 
causes  diarrhea  and  serious  illness. 

Keep  the  weeds  out  of  your  pastures.  Weeds  eaten  by  cows  often  make 
the  milk  strong  and  unfit  for  use. 

Fill  up  the  mud  holes  and  muddy  ponds  in  your  pastures.  Wallowing  in 
mud  holes  makes  the  cow  filthy.  Drinking  water  from  muddy  ponds  is  un- 
wholesome for  dairy  cows. 

Xo  building  should  be  used  for  dairy  cows  which  is  not  well  lighted,  ven- 
tilated and  drained. 

Stable  floors  should  be  solid  and  easily  cleaned.  They  should  be  so  slant- 
ed as  to  give  good  drainage.  Stable  drains  should  be  connected  with  public 
sewers,  if  possible. 

Every  stable  should  be  provided  with  covered  water-tight  receptacles  for 
dung  and  other  refuse.  Refuse  should  not  be  allowed  to  accumulate  on  the 
stable  floor  or  in  the  barnyard. 

^*o  water  closet,  privy,  urinal,  cess  pool,  inhabited  room  or  workshop 
should  be  permitted  to  remain  in  a  dairy  stable.  Chickens,  hogs,  horses, 
sheep  and  goats  should  be  excluded  from  the  cow  barns. 

Five  hundred  cubic  feet  of  air  space  should  be  allowed  for  each  cow  in 
the  barn.  No  stall  should  be  less  thatffour  feet  wide. 

Cow  stables  should  be  kept  clean*  and  should  be  whitewashed  fre- 
quently. Dung  and  refuse  should  be  removed  from  cow  barns  every  day. 
In  the  best  dairies  the  stables  are  cleaned  twice  daily. 

Barn  yards  should  have  solid  ground  in  them.  Cinders  or  gravel  may  be 
used  to  good  advantage.  There  should  be  no  mud  holes.  The  barn  yard 
should  be  graded  for  quick  drainage. 

Each  barn  yard  should  be  provided  with  good  drinking  troughs  which  may 
be  easily  cleaned.  It  is  better  for  the  cows  and  better  for  their  milk  that 
the  drinking  water  be  warmed  in  very  cold  weather. 

Keep  your  cows  clean.  The  best  dairymen  have  their  cows  curried  once 
or  twice  daily.  This  prevents  the  falling  of  loose  hair  or  dirt  into  the  milk 
during  milking.  The  currying  should  be  finished  at  least  twenty  minutes 
before  the  milking  begins. 


23 

The  udders  should  be  washed  with  pure  water  before  each  milking.  The 
hands  of  the  milker  should  be  absolutely  clean. 

The  first  milk  drawn  from  the  udder  contains  the  dirt  and  filth  which 
have  accumulated  in  the  udder.  The  first  few  streams  should  be  drawn  into 
a  waste  bucket.  This  should  not  be  mixed  with  the  milk  which  is  to  be  sold. 

Milk  is  purer  and  better  if  drawn  into  pails  covered  with  perfectly  clean 
cheese-cloth.  The  milk  filters  through  the  cloth  and  many  impurities  are 
removed.  Such  cloths  should  not  be  used  again  until  they  have  been  boiled. 

Do  not  keep  the  milk  in  the  barn  until  several  cows  have  been  milked  or 
until  the  cans  or  pails  are  filled.  The  milk  of  each  cow  should  be  hurried  at 
once  to  the  dairy  house  and  cooled  as  quickly  as  possible.  Milk  standing  in 
open  vessels  in  the  stables  takes  up  foul  odors  and  is  contaminated  with  dust 
and  dirt. 

Rapid  cooling  is  the  greatest  secret  of  pure  milk  production.  Germs  grow 
rapidly  in  warm  milk.  Germ  growth  is  checked  when  the  milk  is  cooled. 
The  quicker  the  cooling  the  purer  the  milk  will  be.  Cool  the  milk  at  once 
after  milking  and  keep  it  cold. 

Every  can.  dipper,  pail,  measure  or  other  utensil  used  in  handling  milk 
should  be  boiled  frequently  and  kept  absolutely  clean. 

After  cooling,  the  milk  should  be  immediately  bottled  and  packed  in  ice. 
All  milk  should  be  bottled  in  the  dairy.  The  customer  is  justified  in  refus- 
ing to  buy  milk  delivered  in  cans. 

Use  no  adulterants  of  any  kind  in  your  milk. 

If  the  milk  is  bloody  or  slimy,  throw  it  away.  Also  throw  away  any  milk 
in  which  dirt  has  fallen, 

Never  sell  the  milk  of  a  sick  cow.  Every  dairyman  should  have  a  small 
lot  where  sick  cows  may  be  separated  from  the  herd.  Isolation  of  sick  cows 
will  often  save  the  entire  herd  from  disease. 

Milk  from  cows  with  cracked  or  sore  udders  should  never  be  sold.  It  is 
often  absolutely  poisonous  to  delicate  infants.  Remember  that  your  milk 
goes  not  only  to  strong  men.  but  to  delicate  babies  as  well. 

Do  not  use  the  milk  from  a  cow  twenty  days  before  calving  nor  for  three 
to  five  days  after. 

Dairymen  having  healthy  herds  should  not  permit  their  calves  to  drink 
skim  milk  from  cows  of  which  they  know  nothing.  Skim  milk  from  cream- 
eries, often  used  by  dairymen  for  feeding,  has  caused  widespread  disease  in 
healthy  herds. 

Aside  from  the  obligations  Imposed  upon  the  dairyman,  in  justice  to  his  cus- 
tomers, to  sell  good  clean  milk,  it  must  be  remembered  that  the  laws  of  the 
State  of  Illinois  establish  certain  standards  tor  milk  and  provide  penalties  for 
their  violation. 

Under  the.  provisions  of  the  law  it  is  a  misdemeanor  to — 

(1)  Adulterate  milk  for  the  purpose  of  sale  for  human  food,  with  water 
or  any  foreign  substance. 

(2)  Knowingly  sell  for  human  food,  milk  from  which  the  cream  has  been 
taken,  without  the  purchaser  being  informed  or  knowing  of  the  fact 

(3)  Knowingly  sell  for  human  food,  milk  from  which  what  is  commonly 
called  "strippings* *  has  been  taken,  without  the  purchaser  thereof  being  in- 
formed or  knowing  the  fact, 

(4)  Knowingly  sell  for  human  food,  milk  drawn  from  a  diseased  cow, 
knowing  her  to  be  so  diseased  as  to  render  her  milk  unwholesome. 

(5)  Knowingly  sell  for  human  food,  milk  so  tainted  and  corrupted  as  to 
be  unwholesome. 


24 

(6)  Keep  cows  for  the  production  of  milk  for  sale  or  exchange  in  an  un- 
healthy condition. 

(7)  Knowingly  feed  cows  upon  food  that  produces  impure,  diseased  and 
unwholesome  milk. 

(8)  Offer  for  sale  in  any  city  of  the  State  any  milk  from  which  the  cream 
or  any  part  thereof  shall  have  been  taken,  or  sell  the  same  except  as  "skim- 

.med  milk,"  and  fail  to  have  each  can  or  vessel  in  which  such  milk  is  car- 
ried or  exposed  for  sale,  plainly  and  conspicuously  marked  wiih  the  words 
"Skimmed  Milk." 

Violations  of  any  of  these  provisions  of  the  law  are  punishable  by  tine  or 
imprisonment  or  both. 

The  law  specifically  provides  that  the  addition  of  water  or 'any  foreign 
substance  to  milk  or  cream  intended  for  sale  or  exchange  is  an  adulteration, 
and  that  any  milk  that  is  obtained  from  cows  fed  on  distillery  waste,  usual- 
ly called  "swill,"  or  upon  any  substance  in  a  state  of  putrefaction,  is  im- 
pure and  unwholesome. 

In  accordance  with  the  law  approved  June  7,  1897,  the  standard  of  analy- 
sis for  milk  in  this  State  as  to  ingredients  and  preparations  shall  be: 
Water,  88  per  cent;  milk  solids,  12  per  cent,  and  such  milk  solids  shall  con- 
tain not  less  than  3  per  cent  of  butter  fat. 


25 


THE  CARE  OF  BABIES. 

(Editorial  in  St.  Louis  Republic.) 

A  very  useful  and  interesting  pamphlet  has  been  issued  by  the  Illinois 
State  Board  of  Health  on  the  care  of  babies  in  summer.  While  this  pam- 
phlet is  sent  to  physicians  it  is  prepared  rather  for  home  distribution,  and 
will  be  mailed  to  anybody  who  will  make  a  request  upon  Doctor  J.  A.  Egan, 
the  Secretary,  at  Springfield.  In  addition  to  practical  advice  on  the  care  of 
infants  there  is  valuable  information  for  mothers.  The  explanations  and 
instructions  are  presented  to  the  best  effect  by  means  of  numerous  illustra- 
tions. 

The  special  virtue  of  the  pamphlet  issued  by  the  Illinois  Board  of  Health 
is  its  clearness.  It  is  written,  not  for  physicians,  but  for  mothers.-  Tech- 
nical terms  are  avoided.  The  directions  are  set  forth  with  magnified  dis- 
tinctness by  means  of  illustrations.  The  contents  embrace  instructions  on 
pure  milk,  diet,  artificial  feeding  and  the  general  care  of  infants,  as  well 
as  information  to  mothers  regarding  the  preservation  of  their  own  health. 

That  the  proper  care  of  infants  would  reduce  the  mortality  and  tend  to 
improve  the  adult  health  is  a  prospect  which  should  increase  interest  in 
authoritative  advice.  What  mothers  do  not  know  about  the  care  and  health 
of  themselves  and  their  children  physicians  do  know;  and  what  the  physi- 
cians know  is  of  particular  usefulness  because  it  is  knowledge  gathered  from 
many  sources  in  regular  practice.  The  summer  is  the  time  for  devoting 
extra  care  to  infants.  And  that  care  should  be  regulated  in  the  manner 
propounded  in  such  pamphlets  as  those  which  the  ever-alert  and  ever-busy 
Illinois  State  Board  of  Health  is  circulating  in  the  homes. 

FOR  YOUR  BABY  OR  YOUR  FRIEND'S  BABY. 

(Chicago  Examiner.) 

The  Illinois  State  Board  of  Health  believes  in  babies,  and  healthy  babies. 
The  Board  has  printed  a  pamphlet  on  "Infant  Feeding,"  with  a  subtitle, 
" Save  the  Babies." 

The  pamphlet  is  well  written.  It  is  not  filled  with  "don't8"butis  strong  on 
suggestions  as  to  what  to  do. 

A  few  days  ago  the  editor  of  the  "EXAMINER"  wrote  to  Dr.  James  A. 
Egan  ind  told  him  that  if  he  would  send  the  pamphlets  to  this  office  the 
"EXAMINER"  would  distribute  them.  Dr.  Egan  sent  a  consignment  yes- 
terday. 

So,  if  you  have  a  baby,  or  a  friend  who  has  a  baby,  and  you  want  to  see 
that  baby  lead  a  healthy  young  life,  call  at  the  "EXAMINER"  office  and 
get  a  Baby  Health  pamphlet. 

If  you  cannot  come,  send  your  name  and  address  and  a  pamphlet  will  be 
sent  you.  The  "EXAMINER"  will  stand  the  postage. 

This  is  one  of  the  best  written  books  on  the  subject  we  ever  saw. 

It  is  for  the  learned  and  unlearned.  It  deserves  to  circulate,  and  just  to 
help  a  good  cause  along  and  to  help  the  babies  the  "EXAMINER"  wants 
to  give  the  work  of  the  State  Board  of  Health  publicity. 


IMPORTANT  NOTICE 

The  Illinois  State  Board  of  Health  has  published  a  circular  on  the  CAUSE 
AND  PREVENTION  OF  CONSUMPTION,  a  preventable  and  curable 
disease,  but  one  which  kills  between  7, 000  and  8, 000  persons  in  Illinois  every 
year;  kills  men  and  women  in  their  prime. 

This  circular  contains  chapters  on  the  following  subjects:  The  CAUSE  OF 
CONSUMPTION,  THE  SYMPTOMS  or  CONSUMPTION,  How  TO  AVOID  CONSUMP- 
TION, How  THE  SPUTUM  MAYBE  DESTROYED,  IF  You  HAVE  CONSUMPTION, 
THE  HYGIENE  OF  THE  SICK-ROOM.  CONSUMPTION  IN  SCHOOLS,  As  TO  CHANGE 
OF  CLIMATE,  AND  As  TO  THE  TREATMENT  OF  CONSUMPTION  IN  ILLINOIS. 

Copies  of  this  circular  will  be  sent  free  of  charge  to  any  person  who  ap- 
plies to  the  Secretary  at  Springfield. 

(IT  In  consumption,  in  the  diseases  oj  infancy  and  childhood,  in  fact  in  all 
diseases  it  is  essential  that  the  premises  be  kept  in  a  sanitary  condition.  All 
decaying  animal  and  vegetable  matter  and  every  kind  and  source  of  filth  in 
and  about  the  house  should  be  removed  and  disinfectants  freely  used.  Sur- 
face drains  and  gutters,  out  houses,  privies,  shelters  for  domestic  animals, 
fowls,  etc.,  and  basements  and  cellars  should  receive  close  and  constant  at- 
tention and  Standard  Disinfectants  No.  1  and  4,  described  on  the  following 
page,  should  be  used  freely  and  regularly  in  such  places. 

This  list  of  Standard  Disinfectants  is  taken  from  the  CIRCULAR  ON 
CONSUMPTION  above  referred  to. 


> 


THE  ILLINOIS  CIRCULAR  ON  CONSUMPTION 

"We  have  received  a  copy  of  a  circular  just  issued  by  the  Illinois  State 
Board  of  Health  on  'The  Cause  and  Prevention  of  Consumption.'  We  regard 
it  as  the  most  complete  and  compact  statement  of  the  cause  and  prevention 
of  this  all-too-universal  and  fatal  disease  that  we  have  seen.  If  a  copy  of 
it  could  be  put  in  every  home  in  the  land  and  was  read  and  its  precepts 
heeded,  Consumption  would  be  reduced  fifty  per  cent  in  ten  years." — From 
Iowa  Health  Bulletin,  August,  1904,  published  by  the  Iowa  State  Board  of 
Health. 


27 

Standard  Disinfectants 

The  following  are  simple,  cheap  and  most  reliable  disinfectants. 

STANDARD  DISINFECTANT  No.  1. 
Four  per  cent  solution  of  Chloride  of  Lime. 

Dissolve  Chloride  of  Lime  of  the  best  quality,  in  water,  in  proportions  of 
six  ounces  of  lime,  to  one  gallon  of  water. 

This  is  one  of  the  strongest  disinfectants  known.  Discharges  from  the 
bowels  of  a  patient  suffering  from  a  contagious  or  infectious  disease,  should 
be  received  in  a  vessel  containing  this  solution,  and  allowed  to  stand  for  an 
hour  or  more  before  being  thrown  into  the  vault  or  water  closet.  Discharg- 
es from  the  throat  or  lungs  should  be  received  in  a  vessel  containing  this 
solution. 

Chloride  of  Lime  in  powder  may  be  used  freely  in  privy  vaults,  cess  pools, 
drains,  sinks  etc. 

Instead  of  the  solution  of  chloride  of  lime,  carbolic  acid  may  be  used  for 
the  same  purpose,  in  a  strength  of  6i  ounces  to  the  gallon  of  water.  This 
makes  a  5  per  cent  solution  of  carbolic  acid. 

STANDARD  DISINFECTANT  No.  2. 
Bichloride  of  Mercury.  1-500. 

Dissolve  corrosive  sublimate  and  muriate  of  ammonia  in  water,  in  the 
proportion  of  two  drachms  (120  grains, — J  ounce)  of  each  to  the  gallon  of 
water.  Dissolve  in  a  wooden  tub,  barrel  or  pail  or  an  earthen  crock. 

Use  for  the  same  purpose  and  in  the  same  way  as  No.  1.  Equally  effect- 
ive but  slower  in  action,  so  that  it  is  necessary  to  let  the  mixture  (disinfec- 
tant and  infected  material)  stand  for  about  four  hours  before  disposing  of 
it.  This  solution  is  odorless,  while  chloride  of  lime  solution  is  often  object- 
ionable in  the  sick  room  on  account  of  its  smell. 

STANDARD  DISINFECTANT  No.  3. 
Bichloride  of  Mercury,  1-1000. 

Dissolve  one  drachm  (60  grains — fr  ounce)  each  of  corrosive  sublimate  and 
muriate  of  ammonia-in  one  gallon  of  water.  Dissolve  in  a  wooden  tub,  bar- 
rel or  pail  or  earthen  crock. 

Use  for  the  disinfection  of  soiled  underclothing,  bed  linen,  etc.  Immerse 
the  articles  for  four  hours,  then  wring  them  out  and  boil  them.  This  solu- 
tion is  excellent  for  wetting  the  floors  of  offices,  stores,  workshops,  halls  and 
school  rooms  before  sweeping. 

Mixed  with  an  equal  quantity  of  water  this  solution  is  useful  for  washing 
the  hands  and  general  surfaces  of  the  bodies  of  attendants. 

(^Chloride  of  lime,  carbolic  acid  and  corrosive  sublimate  are  deadly  poi- 
sons 

STANDARD  DISINFECTANT  No.  4. 
Milk  of  Lime  (Quick  Lime.) 

Slack  a  quart  of  freshly  burnt  lime  (in  small  pieces)  with  three-fourths  of 
a  quart  of  water— or,  to  be  exact,  60  parts  of  water  by  weight  with  100  of 
lime.  A  dry  powder  of  slack  lime  (hydrate  of  lime)  results.  Make  milk  of 
lime  not  long  before  it  is  to  be  used  by  mixing  one  part  of  this  dry  hydrate 
of  lime  with  eight  parts  (by  weight)  of  water. 

Air-slacked  lime  is  worthless.  The  dry  hydrate  may  be  preserved  some 
time  if  it  is  enclosed  in  an  air  tight  container.  Milk  of  lime  should  be 
freshly  prepared,  but  may  be  kept  a  few  days  if  it  is  closely  stoppered. 

Quick  lime  is  one  of  the  cheapest  of  disinfectants.  The  solution  can  take 
the  place  of  chloride  of  lime,  if  desired.  It  should  be  used  freely,  in  quan- 
tity equal  in  amount  to  the  material  to  be  disinfected.  It  can  be  used  to 
whitewash  exposed  surfaces,  to  disinfect  excreta  in  the  sick  room  or  on  the 
surface  of  the  ground,  in  sinks,  drains,  stagnant  pools,  etc. 


